COMPARISON OF AMPICILLIN SULBACTAM VERSUS CLINDAMYCIN IN THE PREVENTION OF INFECTION IN PATIENTS UNDERGOING HEAD AND NECK-SURGERY/

Background. Patients requiring major oncologic head and neck surgery a re at high risk for postoperative wound infection when the surgical si te is contaminated by secretions from the upper aerodigestive tract. S tudies to identify agents active in the prevention of postoperative wo und infection may serve to reduce patient morbidity. Methods. Patients scheduled for a major contaminated head and neck surgical procedure w ere randomly assigned to receive either ampicillin/sulbactam or clinda mycin. Medication was administered 1 to 2 hours prior to surgery and e very 6 hours, for a total of five doses. Postoperatively, patients wer e followed daily for the development of wound infection or other septi c complication. Results. A total of 242 patients were enrolled in the study; 119 received ampicillin/sulbactam, and 123 received clindamycin . A total of 169 patients were considered evaluable. Of the evaluable patients, 14% in each group developed a postoperative wound infection. There were no statistically significant differences between the numbe r of days to onset of wound infection, nor was there a statistically s ignificant difference in the rate of non-wound infections in the two g roups. There were no statistically significant differences between the intent to treat group and the evaluable group of patients. Conclusion . It is concluded that ampicillin/sulbactam is as safe and effective a s clindamycin in preventing postoperative wound infection following ma jor head and neck surgery. (C) 1997 John Wiley & Sons, Inc.